Practice-based study of the cost-effectiveness of fissure sealants in Finland.
OBJECTIVE
To retrospectively analyze the cost-effectiveness of sealant treatment in two health centers with different caries preventive strategies in Finland using a practice-based research protocol.


METHODS
The data of digital dental records were data-mined and analyzed retrospectively in the health center in Kemi where the preventive strategy was sealing selectively only high-caries risk patients, and in Vantaa where all patients were routinely sealed. Risk group determination in Kemi was based on the presence of Streptococcus mutans in dental plaque. Supervised use of xylitol was an additional caries preventive measure in Kemi. The subjects were divided into all-sealed and non-sealed groups in the beginning of the follow-up according to the sealant treatment status of their first permanent molars. The mean cumulative cost of restorations and sealing treatment was counted in children at 12 years of age.


RESULTS
Sealing of risk children in Kemi resulted in a total cost of 185euro per child whereas the respective cost of routinely sealed children in Vantaa was 235euro. The cost of restorations was 76euro in Kemi and 150euro in 5 years in Vantaa. Risk determination and the use of xylitol did not affect significantly the total treatment cost in Kemi.


CONCLUSIONS
The significant reduction in the cost of dental treatment can be achieved by leaving non-risk subjects unsealed and sealing only high-caries risk individuals.
Leskinen
Kaja
K
Department of Cariology, Endodontics and Pediatric Dentistry, University of Oulu, Finland; Public Health Center of Oulu, Finland. kaja.leskinen@oulu.fi
Salo
Sinikka
S
Suni
Jorma
J
Larmas
Markku
M
D017438:Bisphenol A-Glycidyl Methacrylate / Q000191:economics / Q000627:therapeutic use; D002648:Child; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D003729:Dental Care / Q000191:economics*; D003731:Dental Caries / Q000191:economics / Q000517:prevention & control; D003733:Dental Caries Susceptibility; D003773:Dental Plaque / Q000382:microbiology; D003793:Dental Restoration, Permanent / Q000191:economics; D016527:Drug Costs; D005387:Finland; D005500:Follow-Up Studies; D006801:Humans; D008963:Molar; D010895:Pit and Fissure Sealants / Q000191:economics / Q000627:therapeutic use*; D012189:Retrospective Studies; D018570:Risk Assessment; D013295:Streptococcus mutans / Q000302:isolation & purification; D013549:Sweetening Agents / Q000627:therapeutic use; D014993:Xylitol / Q000627:therapeutic use
D010895:Pit and Fissure Sealants; D013549:Sweetening Agents; D017438:Bisphenol A-Glycidyl Methacrylate; D014993:Xylitol